Provider Demographics
NPI:1922992858
Name:MELNEK, DANIELLE PAIGE (NP-C)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:PAIGE
Last Name:MELNEK
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2616 PIPERS CT
Mailing Address - Street 2:
Mailing Address - City:BELLEVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62221-3480
Mailing Address - Country:US
Mailing Address - Phone:618-791-8964
Mailing Address - Fax:
Practice Address - Street 1:200 ADMIRAL TROST RD STE 1A
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:IL
Practice Address - Zip Code:62236-2164
Practice Address - Country:US
Practice Address - Phone:618-281-7373
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-05
Last Update Date:2025-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041536934363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care